Healthcare Provider Details

I. General information

NPI: 1992861694
Provider Name (Legal Business Name): WESTSIDE COMMUNITY MENTAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PIERCE ST
SAN FRANCISCO CA
94115-4005
US

IV. Provider business mailing address

1153 OAK ST
SAN FRANCISCO CA
94117-2216
US

V. Phone/Fax

Practice location:
  • Phone: 415-563-8200
  • Fax: 415-563-5985
Mailing address:
  • Phone: 415-431-9000
  • Fax: 415-431-1813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MARY ANN JONES
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: PHD
Phone: 415-431-9000